Inspection·May 2, 2019

F 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and staff interview, the facility failed to ensure a resident's Minimum Data Set (MDS) assessment was coded accurately for restorative nursing programs (RNP). This affected one (Resident #19) of one residents reviewed for limited range of motion. The facility identified 12 residents (#1, #4, #6, #8, #9, #10, #11, #13, #14, #16, #19, and #20) participating in a RNP. The facility census was 20. Residents Affected - Few Findings include: Review of Resident #19's medical record revealed an admission date of 06/03/15. Medical diagnoses included athetoid cerebral palsy, generalized muscle weakness, involuntary movements, hypertension, dorsalgia, and asthma. Review of the resident's MDS assessment dated [DATE] revealed the resident had functional limitation in range of motion (ROM) in bilateral upper and lower extremities. He received RNP for passive ROM five out of seven days of the look back assessment period. The resident participated in active ROM four of seven days of the look back assessment period. Review of the documentation for the resident's RNP for the look back assessment period for the 01/09/19 MDS revealed he received three days of passive ROM and three days of active ROM. Review of the resident's MDS assessment dated [DATE] revealed the resident received RNP for passive range of motion (ROM) six out of seven days of the look back assessment period. The resident participated in active ROM six of seven days of the look back assessment period. Review of the documentation for the resident's RNP for the look back assessment period for the 04/10/19 MDS revealed he received three days of passive ROM and six days of active ROM. Interview with the Director of Nursing on 05/01/19 at 8:27 A.M. verified the resident's 01/09/19 MDS was coded incorrectly for active and passive RNP. She also verified the resident's 04/10/19 MDS was coded incorrectly for passive ROM. The facility identified 12 residents (#1, #4, #6, #8, #9, #10, #11, #13, #14, #16, #19, and #20) participating in a RNP. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 2 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review and staff interview, the facility failed to ensure a resident's care plan was revised to address a change in skin condition. This affected one (Resident #12) of one residents reviewed for pressure ulcers. The facility identified only one resident with a pressure ulcer. The facility census was 20. Findings include: Review of Resident #12's medical record revealed an admission date of 05/18/18. Medical diagnoses included generalized muscle weakness, malignant neoplasm of mouth, chronic kidney disease, chronic atrial fibrillation, abdominal aortic aneurysm, and gastrointestinal hemorrhage. Review of the resident's Minimum Data Set (MDS) assessment dated [DATE] revealed a brief interview for mental status (BIMS) score of 15, indicating no impairment in cognition. He was identified as at risk for pressure ulcers. Review of the resident's wound documentation revealed two unstageable pressure ulcers developed on his right and left great toes on 04/09/19. Review of the resident's skin care plan created on 01/25/19 and revised on 04/30/19 revealed no mention of the impairment to the resident's right and great toes and no interventions to address these concerns. Interview with the Director of Nursing on 04/30/19 at 6:26 P.M. verified Resident #12's skin care plan was not updated to reflect the unstageable pressure areas to his right and left great toes. She stated the facility did not have a policy regarding updating care plans, they follow the Resident Assessment Instrument guidelines. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 3 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, and resident and staff interview, the facility failed to ensure a resident's restorative nursing program (RNP) was implemented as planned. This affected one (Resident #19) of one residents reviewed for limited range of motion. The facility identified 12 residents (#1, #4, #6, #8, #9, #10, #11, #13, #14, #16, #19, and #20) participating in a RNP. The facility census was 20. Findings include: Review of Resident #19's medical record revealed an admission date of 06/03/15. Medical diagnoses included athetoid cerebral palsy, generalized muscle weakness, involuntary movements, hypertension, dorsalgia, and asthma. Review of the resident's physical therapy Discharge summary dated [DATE] revealed his prognosis to maintain current level of function was good with strong family support and consistent follow through. Recommendation was for a restorative program. Review of the resident's rehabilitation screens dated 12/24/18 and 03/20/19 revealed he did not demonstrate any changes since his last screen. No therapy orders were needed. The screens indicated the resident was not currently in a restorative program. Review of the resident's care plan revealed a care plan revised on 03/26/18 revealed for a RNP. The plan indicated therapy had worked with him to establish a RNP. He needed stretching because of his diagnosis of spastic cerebral palsy. His goal was to maintain the use of his computer mouse and manage certain items on his desk and to maintain stand pivot transfers to and from the toilet. The plan included active ROM shoulder flexion five to ten times daily, leaning back in his chair and raising his arm above his head, repeating on both sides daily. The plan indicated he may need assistance. Active ROM also included horizontal abduction, seated trunk flexion, and resistance band exercises. His plan included passive ROM dorsiflexion stretch, foot pronation supination, knee extension stretches, hip abduction/adduction, hip flexion/extension, shoulder flexion/extension, finger flexion/extension. The passive ROM was to be completed twice daily. Review of restorative nursing program documentation for passive and active ROM for April 2019 revealed active ROM was completed once daily as scheduled. Passive ROM was not documented as completed twice daily for 21 of 30 days. Continued review of the resident's medical record revealed no updated assessment of resident's progress with RNP since 08/04/17. Review of the resident's Minimum Data Set (MDS) assessment dated [DATE] revealed the resident had a brief interview for mental status score of 15, indicating no impairment in cognition. He had no rejection of care. He required extensive assistance with two plus staff for bed mobility, transfers, and dressing. He required extensive assistance with one staff for toilet use and hygiene. The resident had functional limitation in ROM bilaterally upper and lower extremities. He received RNP for passive range of motion (ROM) six out of seven days of the look back assessment period. The resident participated in active ROM six of seven days of the look back assessment period. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 4 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview with the Resident #19 on 04/29/19 at 2:04 P.M., revealed he had limited ROM to bilateral arms and legs and hands. He stated staff were supposed to assist him with ROM once daily, but it only occurred once or twice per week. Interview with the Director of Nursing (DON) on 04/30/19 verified there had been no evaluation of the resident's RNP documented since his most recent RNP plan was implemented on 03/06/18. She also verified she had no documentation indicating the resident's RNP was completed as planned for 21 of 30 days in April 2019. Interview with Certified Occupational Therapy Assistant (COTA) #101 on 05/01/19 at 8:43 A.M., verified the resident's status in a RNP was not accurately identified in his two most recent therapy screens. She stated she completed the screen on 03/20/19. She stated she asked the State Tested Nursing Assistant if the resident was on a restorative program and she was told he was not. She stated she looked in the resident's hard chart but not the electronic health record. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 5 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0692 Provide enough food/fluids to maintain a resident's health. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, staff interview, and review of a facility procedure manual, the facility failed to ensure dietary assessments accurately reflected a resident's skin condition. This affected one (Resident #12) of one residents reviewed for pressure ulcers. The facility identified only one resident with a pressure ulcer. The facility census was 20. Residents Affected - Few Findings include: Review of Resident #12's medical record revealed an admission date of 05/18/18. Medical diagnoses included generalized muscle weakness, malignant neoplasm of mouth, chronic kidney disease, chronic atrial fibrillation, abdominal aortic aneurysm, and gastrointestinal hemorrhage. Review of the resident's Minimum Data Set (MDS) assessment dated [DATE] revealed a brief interview for mental status (BIMS) score of 15, indicating no impairment in cognition. He was identified as at risk for pressure ulcers and had moisture associated skin damage. Review of the resident's nutrition care plan dated 06/01/18 revealed the resident was at risk for impaired nutritional status. One of his goals was to maintain skin integrity. Interventions included monitoring skin per nursing protocol. Continued review of the resident's medical record revealed he was identified as having impaired areas to his buttocks associated with moisture on 01/09/19. He was assessed as having a stage two pressure ulcer to the right buttock and unstageable pressure ulcers to the right and left great toes on 04/09/19. Review of the resident's quarterly dietary assessments dated 01/21/19 and 04/19/19 his skin was intact with no recommendations indicated. Review of the resident's physician's orders revealed no orders for increased protein until 04/23/19 when protein Jell-O was ordered once daily. Interview with Dietary Technician (DT) #145 on 04/30/19 at 12:21 P.M., verified she did not include information regarding the resident's skin impairment in her dietary assessments dated 01/21/19 and 04/19/19. She stated she was not aware of the resident's skin impairments. She stated the facility staff would normally notify her verbally. She stated she must have missed this information in the resident's medical record. She verified she would have recommended a high protein supplement to promote wound healing in a resident with skin impairment. Review of an undated facility procedure manual titled Dietary Procedure Manual revealed quarterly assessment updates were written for all nursing home residents. The Registered Dietitian reviews the medical record for current physician's orders, recent lab data, Minimum Data Set assessment, interdisciplinary care plan, and recent interdisciplinary progress notes for changes since last progress note was written. Review may include other pertinent records available such as data sheets, medication administration record, and skin evaluations. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 6 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, medical record review, staff interview, and review of a facility policy, the facility failed to ensure accurate labeling of resident medications. This affected one (Resident # 1) of six residents observed for medication administration. The facility census was 20. Findings include: Review of Resident #1's medical record revealed an admission date of 11/26/18. Medical diagnoses included unspecified dementia with behavioral disturbance, paranoid personality disorder, anxiety disorder, chronic obstructive pulmonary disease, hypertension, insomnia, and major depressive disorder. Observation of medication administration on 05/01/19 at 8:02 A.M. for Resident #1 with Registered Nurse (RN) #124 revealed she administered 75 milligrams (mg) of Seroquel (antipsychotic) to the resident. Review of the Seroquel label revealed the resident was to receive 50 mg in the morning and 75 mg at night. The resident had two bottles of Seroquel labeled in this manner. Handwritten across the lid of the bottle was dose change. Continued review of the resident's medical record revealed the most current Seroquel order was for 75 mg twice daily dated 04/01/19. Interview with RN #124 at time of observation verified the resident's Seroquel label did not correlate with her current physician's order dated 04/01/19. Review of a facility policy titled Medication Ordering and Receiving from Pharmacy revised on 10/22/07 revealed the dispensing pharmacy will be informed prior to the next refill of the prescription so the new container will show an accurate label. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 7 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, staff interview and review of facility policy, the facility failed to ensure food was stored in a sanitary condition. The facility identified 10 (Residents #2,#3, #4, #7, #8, #10, #16, #17, #18 and #20) residents as receiving meals from the [NAME] House kitchen. The facility census was 20. Findings Include: Observation during the initial tour of the kitchen in the [NAME] House with State Tested Nurse Aide (STNA) #142 on 04/29/18 at 10:15 A.M. revealed one clear plastic bag half full of frozen shoestring french fries, one bag of half full frozen sweet potato french fries and one bag three quarters full of frozen turkey filets that had been previously opened. None of the three opened plastic bags contained labeling or dating of the items. Interview with STNA #142 on 04/29/19 at 10:15 A.M. during the observation confirmed the items had been opened and were silent for labeling and/or dating. Review of the facility provided undated policy titled, Date Marking revealed potentially hazardous leftover food will include the beginning and ending date on the container. The beginning date was the date opened, ending date was seven days after beginning date starting with beginning date as day one. All opened containers would include the date that it was opened. Staff would use masking tape and a black marker to do the labeling. The facility identified 10 (Residents #2,#3, #4, #7, #8, #10, #16, #17, #18 and #20) residents as receiving meals from the [NAME] House kitchen. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 8 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0881 Implement a program that monitors antibiotic use. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on medical record review, facility infection tracking logs, staff interview, and review of a facility policy, the facility failed to ensure a resident's prescribed antibiotic was in accordance with the Antibiotic Stewardship program. This affected one resident (#2) of one resident reviewed for urinary tract infections. The facility census was 20. Residents Affected - Few Findings include: Medical record review for Resident #2 revealed an admission date of 08/27/18. Diagnoses included iron deficiency anemia, hypokalemia, transient cerebral ischemic attack, cardiac arrhythmia, myelodysplastic syndrome (deficient production of blood cells in bone marrow), anxiety disorder, epistaxis, cardiac pacemaker, major depressive disorder, muscle weakness, difficulty walking, heart failure, urinary tract infection site not specified, insomnia, anxiety disorder, diaphragmatic hernia, pulmonary fibrosis, age related osteoporosis, hypothyroidism, type two diabetes, and hyperlipidemia. Review of Resident #2's medication administration records (MARs) for October 2018 and November 2018 revealed Macrobid (antibiotic) 100 milligrams (mg) was administered daily for prophylaxis of urinary tract infections. The antibiotic was subsequently discontinued on 12/15/18. Further review of Resident #2's medical record revealed a urinalysis was completed on 12/24/18 with abnormalities, but no growth after 48 hours. Review of the physician orders for Resident #2 revealed an order dated 12/24/18 for Macrobid (antibiotic) 100 milligrams (mg) one tablet orally daily for prevention of urinary tract infections (UTI's). The physician order gave no ending date for the use of the antibiotic. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #2 had a Brief Interview Mental Status (BIMS) of three indicating severely impaired cognition. The MDS further revealed Resident #2 to be incontinent of urine with no documented urinary tract infections in the last 30 days. Continued review of the MARs for 12/24/18 through 04/30/19 revealed the Macrobid to be administered daily as ordered prophylactically for urinary tract infections. Review of the facility infection control logs for January, February, March and April 2019 revealed them to be silent for documentation of a urinary tract infection for Resident #2. Review of the medical record for Resident #2 revealed the pharmacy did monthly medication reviews as required from August 2018 through April 2019. The pharmacy failed to recognize/question/make recommendations to the physician regarding the continued use of an antibiotic with no stop date indicated. Interview on 04/30/19 at 10:13 A.M. with the Director of Nursing (DON) revealed the Macrobid had been stopped prior to 12/24/18 and Resident #2 incurred a UTI. The DON reported the resident had not had any UTI's since the implementation of the prophylactic antibiotic Macrobid. The DON confirmed Resident #2's last UTI was the end of December 2018. The DON further reported having conversation with the physician regarding the regulation requirement and indicated the physician ordered the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 9 of 10 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2019 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Willow Ridge of Mennonite Home Communities of Ohio 101 Willow Ridge Drive Bluffton, OH 45817 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0881 continuation of the prophylactic medication. Level of Harm - Minimal harm or potential for actual harm Review of the facility provided policy titled, Antibiotic Stewardship Program with a revision date of 04/09/19 revealed the DON/Nursing Staff would assess and monitor the antibiotic prescribing practices (documentation of the indication, dose, and duration of the antibiotic, review laboratory reports) to determine if the antibiotic is indicated or needs to be adjusted. The policy also contained the minimum criteria for common infections (urinary tract infections, lower respiratory infections and skin/soft tissue infections). The policy indicated the facility would use the minimum criteria for the three common infections implemented 10/05/17 to improve appropriate antibiotic use for the residents. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366402 If continuation sheet Page 10 of 10